Dental payment adjustment (percent of the fee schedule): Medicaid rates by state
3 states publish a Medicaid rate for dental payment adjustment (percent of the fee schedule). The median is —; rates range from $60.00 in Hawaii to $105.00 in Ohio.
- States
- 3
- Median
- —
- Highest
- $105.00Ohio
- Lowest
- $60.00Hawaii
- Rates on file
- 4
Dental payment adjustment (percent of the fee schedule): highest and lowest states
Headline rate per state for the same provider level, as published.
How dental payment adjustment (percent of the fee schedule) is compared
This is a service-level benchmark rather than a single code: each state's headline rate for dental payment adjustment (percent of the fee schedule) is chosen to match the same service and the same provider level.
- Provider level. States are compared at the same provider level wherever the schedule distinguishes one. Rates for other levels on file (any qualified provider) are kept separate, never mixed into this ranking.
- Unit. Of the 3 states, 1 publish their headline rate per one hundred five per cent of the amount listed in appendix dd, 1 per percent and 1 per % of the average code average of the 2 major commercial dental plans for oahu (previous 12 months). The ranking uses the rate as published, so read the unit before comparing two states.
- Variants. 1 of the 3 states publish more than one rate for this service (by modifier, program, setting or provider type); the headline rate is the one that matches the comparison, and the workspace lists every variant.
- Depth. 4 rates for this service are on file across all states, versions and provider levels; this page shows one headline rate per state.
Why dental payment adjustment (percent of the fee schedule) rates differ between states
The highest-paying state, Ohio, pays $105.00; the lowest, Hawaii, pays $60.00, a 1.8x gap. 3 of the 3 states pay above the median of —. Common reasons rates for dental services spread this way:
- Federal rules require dental coverage for children through EPSDT, while adult dental benefits are optional and range from emergency-only to comprehensive.
- Many states run dental through a dental benefit administrator, and fee updates are often infrequent compared with medical schedules.
- Some states publish separate child and adult fees for the same procedure, or pay specialists more than general dentists.
Billing notes
Frequency limits, such as how often an exam or cleaning is covered, decide whether a service is paid at all, regardless of the fee. Dental codes (CDT, maintained by the American Dental Association) are paid once per procedure, with the tooth number and surfaces on the claim.
Frequently asked questions
Which state pays the most for dental payment adjustment (percent of the fee schedule)?
Ohio: $105.00 per one hundred five per cent of the amount listed in appendix DD.
Which state pays the least for dental payment adjustment (percent of the fee schedule)?
Hawaii: $60.00 per % of the average code average of the 2 major commercial dental plans for Oahu (previous 12 months).
What is the average Medicaid rate for dental payment adjustment (percent of the fee schedule)?
Across 3 states the median is —, comparing the same provider level in each state. 3 states pay above it.
How are the states compared?
One headline rate per state, matched on the service and provider level, as published. Rates for other provider levels and add-ons are not mixed in.
What unit is dental payment adjustment (percent of the fee schedule) billed in?
Of the 3 states, 1 publish it per one hundred five per cent of the amount listed in appendix dd, 1 per percent and 1 per % of the average code average of the 2 major commercial dental plans for oahu (previous 12 months).
Do managed-care plans pay these rates?
It depends on the state. Each state's managed-care page shows whether plans must pay at least the published rate, follow a state-set rate, or negotiate their own for this service line.